How much rates vary
Facilitymedian $2,754 · 10th to 90th $708 to $15,488Professionalmedian $1,479 · 10th to 90th $1,047 to $2,570
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,348.96 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,380.38 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,041.74 Typical High $3,235.94 | Professional | 50 · Both sides | $1,584.89 | $2,041.74 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $870.96 Typical High $1,380.38 | Professional | 62 · Two surgeons | $660.69 | $870.96 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $218.78 Typical High $346.74 | Professional | 80 · Assistant surgeon | $169.82 | $218.78 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $190.55 Typical High $302.00 | Professional | AS · PA/NP assist | $147.91 | $190.55 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $12,882.50 Typical High $16,982.44 | Facility | None | $707.95 | $12,882.50 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,513.56 | $2,187.76 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,047.13 | $1,698.24 | $2,630.27 |
Martin's Point Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,348.96 | $2,630.27 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,348.96 | $1,819.70 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $549.54 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $223.87 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $831.76 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $165.96 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $109.65 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $776.25 | $954.99 | $954.99 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $630.96 | $676.08 | $676.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $251.19 | $269.15 | $269.15 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $954.99 | $1,023.29 | $1,023.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $190.55 | $204.17 | $204.17 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $125.89 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $891.25 | $954.99 | $954.99 |
Where Maine sits
The same service costs 6.0 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $15,585KY $2,601
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.